奥瑞珠单抗治疗多发性硬化相关噬血细胞性淋巴组织细胞增生症
Hemophagocytic lymphohistiocytosis associated with ocrelizumab treatment in a patient with multiple sclerosis.
机构信息
Center of Neurology, Lodz, Poland.
Department of Hematology and Bone Marrow Transplantation, Silesian Medical University, Katowice, Poland.
出版信息
Mult Scler. 2021 Oct;27(11):1803-1805. doi: 10.1177/1352458521993070. Epub 2021 Mar 5.
BACKGROUND
Hemophagocytic lymphohistiocytosis (HLH) is a rarely recognized hyperinflammatory condition of high death risk.
OBJECTIVE
The objective was to describe a case of HLH in a patient with multiple sclerosis (MS) treated with ocrelizumab.
METHODS
Clinical observation, laboratory testing, and use of HLH-2004 criteria for HLH diagnosis.
RESULTS
A 32-year-old Caucasian female developed HLH during ocrelizumab treatment. She met six of the eight HLH criteria including fever, splenomegaly, cytopenia, hypertriglyceridemia and hypofibrinogenemia, high serum ferritin level, and low natural killer (NK) cells.
CONCLUSION
HLH should be considered in the differential diagnosis in MS patients displaying a fever and malaise syndrome following administration of ocrelizumab.
背景
噬血细胞性淋巴组织细胞增生症（HLH）是一种罕见的高风险炎症过度活跃病症。
目的
描述一例接受奥瑞珠单抗治疗的多发性硬化症（MS）患者发生 HLH 的病例。
方法
采用 HLH-2004 标准进行 HLH 诊断，观察临床表现、实验室检查。
结果
一名 32 岁的白人女性在接受奥瑞珠单抗治疗期间发生 HLH。她符合 HLH 的八项标准中的六项，包括发热、脾大、血细胞减少、高甘油三酯血症和低纤维蛋白原血症、血清铁蛋白水平升高以及自然杀伤（NK）细胞减少。
结论
在接受奥瑞珠单抗治疗后出现发热和不适综合征的 MS 患者中，应考虑 HLH 作为鉴别诊断。
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